新生儿坏死性小肠结肠炎患儿的远期预后

Long-term prognosis of neonates with necrotizing enterocolitis

摘要:

目的 了解新生儿坏死性小肠结肠炎（NEC）患儿的远期预后。方法 将2014年12月至2016年9月存活出院的83例NEC早产儿分为手术组（n=57）和非手术组（n=26）。手术组Ⅰ期、Ⅱ期、Ⅲ期NEC患儿分别有0、33、24例，非手术组分别有7、19、0例。对患儿出院后体格发育、神经系统发育等情况进行随访分析。结果 83例患儿随访结束时平均纠正年龄为21±6个月。31例（37%）体重落后，其中手术组体重落后率高于非手术组（P < 0.05）；22例（27%）身长落后；14例（17%）头围落后。运动发育落后/发育障碍患儿共18例（22%），其中手术组发生率高于非手术组（28% vs 8%，P < 0.05）。共有5例（6%）患儿诊断为脑瘫，其中手术组4例，非手术组1例。结论 NEC会影响患儿的远期体格发育及神经系统发育等，尤其对病情严重需接受手术治疗的患儿影响更大，应对NEC患儿进行长期随访。

Abstract:

Objective To investigate the long-term prognosis of neonates with necrotizing enterocolitis (NEC).Methods A total of 83 preterm infants with NEC who survived and were discharged between December 2014 and September 2016 were enrolled and divided into surgery group (n=57) and non-surgery group (n=26). There were 0, 33 and 24 cases of stage I, Ⅱ and Ⅲ NEC respectively in the surgery group and 7, 19 and 0 cases respectively in the non-surgery group. The physical development and neurodevelopmental outcomes of the infants were followed up after discharge.Results Of the 83 infants, the mean corrected age at the end of follow-up was 21±6 months. Of the 83 infants, 31 (37%) had subnormal body weight, and the surgery group had a higher rate of subnormal body weight than the non-surgery group (P < 0.05). Twenty-two infants (27%) had subnormal body length and 14 children (17%) had subnormal head circumference among the 83 infants. Eighteen infants (22%) had motor developmental delay/developmental disorders, and the surgery group had a higher incidence rate of the disorders than the non-surgery group (28% vs 8%; P < 0.05). Five infants (6%) were diagnosed with cerebral palsy, among whom 4 were in the surgery group and 1 was in the non-surgery group.Conclusions Long-term physical development and neurodevelopmental outcomes may be adversely affected in neonates with NEC, in particular in those with severe conditions who need surgical treatment, suggesting that long-term follow-up should be performed for neonates with NEC.